• Radiation Oncology Journal
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• v.22 no.3
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• pp.192-199
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• 2004

Purpose: To determine the patterns on evaluation and treatment in the patient with early breast cancer treated with conservative surgery and radiotherapy and to improve the radiotherapy techiniques, nationwide survey was peformed. Materials and Methods: A web-based database system for korean Patterns of Care Study (PCS) for 6 common cancers was developed. Two hundreds sixty-one randomly selected records of eligible patients treated between 1998$\~$1999 from 15 hospitals were reviewed. Results: The patients ages ranged from 24 to 85 years(median 45 years). Infiltrating ductal carcinoma was most common histologic type (88.9$\%$) followed by medullary carcinoma (4.2$\%$) and infiltrating lobular carcinoma (1.5$\%$). Pathologic T stage by AJCC was T1 in 59.7$\%$ of the casses, T2 in 29.5$\%$ of the cases, Tis in 8.8$\%$ of the cases. Axillary lymph node dissection was peformed I\in 91.2$\%$ of the cases and 69.7$\%$ were node negative. AJCC stage was 0 in 8.8$\%$ of the cases, stage I in 44.9$\%$ of the cases, stage IIa in 33.3$\%$ of the cases, and stage IIb in 8.4$\%$ of the cases. Estrogen and progesteron receptors were evaluated in 71.6$\%$, and 70.9$\%$ of the patients, respectively. Surgical methods of breast-conserving surgery was excision/lumpectomy in 37.2$\%$, wide excision in 11.5$\%$, quadrantectomy in 23$\%$ and partial mastectomy in 27.5$\%$ of the cases. A pathologically confirmed negative margin was obtained in 90.8$\%$ of the cases. Pathological margin was involved with tumor in 10 patients and margin was close (less than 2 mm) in 10 patients. All the patients except one recieved more than 90$\%$ of the planned radiotherapy dose. Radiotherapy volume was breast only In 88$\%$ of the cases, breast+supraclavicular fossa (SCL) in 5$\%$ of the cases, and breast+ SCL+ posterior axillary boost in 4.2%$\%$of the cases. Only one patient received isolated internal mammary lymph node irradiation. Used radiation beam was Co-60 in 8 cases, 4 MV X-ray in 115 cases, 6 MV X-ray in 125 cases, and 10 MV X-ray in 11 cases. The radiation dose to the whole breast was 45$\~$59.4 Gy (median 50.4) and boost dose was 8$\~$20 Gy (median 10 Gy). The total radiation dose delivered was 50.4$\~$70.4 Gy (median 60.4 Gy). Conclusion: There was no major deviation from current standard in the patterns of evaluation and treatment for the patients with early breast cancer treated with breast conservation method. Some varieties were identified in boost irradiation dose. Separate analysis for the datails of radiotherapy planning will be followed and the outcome of treatment is needed to evaluate the process.

• Korean Journal of Clinical Laboratory Science
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• v.55 no.2
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• pp.113-120
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• 2023

The hypertriglyceridemic-waist (HTGW) phenotype can predict the risk of coronary artery disease. This study evaluated the relationship between the HTGW phenotype and metabolic abnormalities in hypertensive adults. The test was conducted on adult hypertension patients aged 20 or older who underwent health checkups from January 2018 to December 2021 at general hospitals in Gyeonggi Province. The HTGW phenotype was triglyceride ≥150 mg/dL and waist circumference ≥90 cm for men and ≥85 cm for women. The prevalence of the HTGW phenotype in the study subjects was 17.9%. After adjusting for age, gender, and BMI, the odds ratio of the HTGW group was 5.09 (95% confidence interval [CI]: 3.545~7.309) for low HDL-cholesterol, 1.68 (95% CI: 1.176~2.411) for high LDL-cholesterol, was 2.92 (95% CI: 2.009~4.235) for high total cholesterol, 3.39 (95% CI: 2.124~5.412) for diabetes and 1.85 (95% CI: 1.286~2.674) for hyperuricemia compared to the normal triglyceride levels with the normal waist (NTNW) group. The area under curve values of the HTGW phenotype for diagnosing metabolic syndrome were 0.849 for all subjects, 0.858 for men, and 0.890 for women. In conclusion, the HTGW phenotype is closely related to metabolic abnormalities and is a useful indicator for monitoring adult hypertensive patients with metabolic syndrome.

• Quality Improvement in Health Care
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• v.7 no.2
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• pp.138-155
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• 2000

Background: Factors related to waiting and staying time for patient care in emergency care center (ECC) were examined during 1 month from Apr. 1 to Apr. 30, 1997 at an ECC of Yeungnam university hospital in Taegu metropolitan city, to obtain the baseline data on the strategy of effective management of emergency patients. Method: The study subjects consisted of the 1,742 patients who visited at ECC and the data were obtained from the medical records of ECC and direct surveys. Results: The mean interval between ECC admission time and initial care time by each ECC duty residents was 83.1 minutes for male patients and 84.9 minutes for female patients, and mean ECC staying time (time interval between admission and final disposition from ECC) was 718.0 minutes in men and 670.5 minutes in women. As the results, the mean staying time in ECC was higher in older age, and especially the both of initial care time and staying time were highest in patients of medical aid, and shortest in patients of worker's accident compensation insurance. The on admission or not, previously endotracheal-intubation state of patient. The ECC staying ti initial care time was much more delayed in patients of not having previous medical records and the ECC staying time was higher in referred patients from out-patient department, in transferred patients from the other hospitals and patients having previous records, and in patients partly used the order-communicating system. The factors associated with the initial care time were the numbers of ECC patients and the existence of any true emergent patients, being cardiopulmonary resuscitation (CPR) statusme was much more longer in patients of drug intoxication, in CPR patients, in medical department patients, in transfused patients and in patients related to 3 or more departments. And according to the numbers of duty internships, the ECC staying time for four internships was more longer than for five internships and after admission ordering was done, also-more longer in status being of no available beds. As above mentioned results, the factors for the ECC staying time were thought to be statistically significant (P<0.01) according to the patient's age and the laboratory orders and the X-ray films checked. And also the factor for the ECC staying time were thought to be statistically significant (P<0.01) according to the status being of no available beds, the laboratory orders and/or the special laboratory orders, the X-ray films checked, final disposing department, transferred to other hospital or not, home medication or not, admission or not, the grades of beds, the year grades of residents, the causes of ECC visit, the being CPR status on admission or not, the surgical operation or not, being known personells in our hospital. Conclution: Authors concluded that the relieving method of long-staying time in ECC was being establishing the legally proved apparatus which could differentiate the true emergency or non-emergency patients, and that the methods of shortening ECC staying time were doing definitely necessary laboratory orders and managing beds more flexibly to admit for ECC patients and finally this methods were thought to be a method of unloading for ECC personnels and improving the quality of care in emergency patients.

• The Korean Nurse
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• v.35 no.2
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• pp.71-91
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• 1996

The objectives of thes study were to identify the need for equipment development in nursing, and to determine the priorities for that development. The study was descriptive study done between March 2 and May 30, 1995, in which the subjects, including 421 patients, 223 family members, and 198 nurses from neurosurgery, orthopedic, rehabilitation medicine, internal medicine and intensive care units of nine general hospitals in Seoul, completed a questionnarie developed by the research team. The questionnaire consisted of 35 open and closed questions. Data was analyzed using frequencies and percentages. The results ware summarized as follows: 1) The average age of the nurses was 27.9 years, 48% of the patients were between 20 and 40 years of age, and 17% were over 60. The average lingth of experience for the nurse subjects was four years five months with 36.9%. having over five years experience. The most frequent diagnoses of patients were spinal disc(35.9%), internal medicine disease(26.0%), cerebral vascular accident(16.6%) and spinal cord injury(10%) 2) Many of the nurses(96.4%) reported deficiencies with existing equipment and 96.5% of the nurses, but only 79.8% of the patients, nurses' time. Further, 82.3% of the nurses and 75.8% of the patients felt that the development of new equipment would lead to a decrease in the cost of nursing care. 3) Nurses felt that the greatest areas of inconvenience were patient feeding(71.7%), hygiene(71.2%), caring for a patient confined to bed(70.7%), patient clothing(67.2%), mobility transfers(63.5%) and urinary elimination(52.0%). However, patients and family members listed the following as being the most inconvenient: urinary elimination(58.7%), Hygiene(50.5), feeding(48.4%), mobility transfers(47.1%) and bed care(45.2%). 4) Generally the nurses listed more inconveniences and patients and family members listed more demands for the development of equipment. These included utensils with large handles, and regulators for tube feedings; mattresses that provide for automatic position change and massage, which have patient controlled levers and a place for bed pan insertion; automatic lifts or transfer from bed to wheelchair; equipment to facilitate washing and oral hygiene as well as equipment that will allow patients with spinal cord injuries easy access to showers; a bed pan/urinal for women that is comfortable and effective from which urine can be measured and disposed of easily; disposable dressing sets and tracheostomy care sets and a convenient way of measuring changes in wound size; a safe delivery system for oxygen, a variety of mask sizes and better control of humidity, tracheal material than at present, as well as a communication system for patients with tracheostomies; clothing that will allow access to various parts of the body for treament or assessment without patients having to remove all of their clothing; and finally a system that will allow the patient to control lighting, telephones and pagers. Priority areas for equipment development reported by the nurses were, urinary elimination(58. 7%), hygiene(50.5%), feeding(48.4%), mobility transfers(47..1%), bowel elimination(40.8%). Those reported by the patients family members were feeding(71.7%), hygiene(70.0%), bedcare(70.7%), clothing(67.2%), mobility transfers(63.6%), urinary elimination(52.9%) and bowel elimination(50.5%) Altogether, nurses, patients and family members listed the following as priorities; clothing (178), bed care(144), urinary elimination(92), environment(81), hygiene(70). Further, a health professional forum listed urinary elimination, oxygen delivery, medication delivery, mobility transfers, bed care and hygiene in that order as priority areas. From this study it can be concluded that the first need is to develop equipment that will address the problems of urinary elimination. To do (l)This nurses who are interested in equipment development should organize an equipment development team to provide a forum for discussion and production of equipment for nursing.

• Clinical and Experimental Pediatrics
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• v.49 no.12
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• pp.1282-1286
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• 2006

Purpose : The causes of prolonged fever have changed during the years and are influenced by age, geographic location and availability of diagnostic facilities/techniques. The aim of the present study was to determine the causes of prolonged fever, to know the proportion and outcomes of undiagnosed children. Methods : We reviewed patients with fever persisting for more than 2 weeks in duration, with documented temperatures of $38^{\circ}C$ on several occasions, or uncertain diagnosis after intensive study of 1 week duration in other hospitals who were admitted to Pusan National University Hospital during the period from July 1999 to June 2004. Results : Fifty-four (59.0 percent) were boys and thirty-seven (41 percent) were girls. Forty-six cases were less than 6 years and 45 cases were more than 6 years; the mean age was $6.48{\pm}6.56years$. In 62 cases (68.1 percent), the fever had persisted for 2 to 3 weeks before admission and in 26 cases (28.6 percent), had lasted longer than a month. Final diagnosis had been reached in 66 of 91 children (72.5 percent). The most common cause was infection (38/91), followed by collagen vascular disease (12/91), immune deficiency (3/91), neoplasia (2/91), and miscellaneous disease. Tuberculosis was the most common infectious cause. The causes of fever were not revealed in 25 cases. Outcome on discharge were as follows; 77 cases (84.6 percent) were improved, 10 cases (11.0 percent) discharged without improvement and 4 cases (4.4 percent) expired. Conclusion : The most common cause of prolonged fever in Korean children remains infection, but the incidence of infection was decreased as compared with previous studies. Tuberculosis is the most common among infectious causes. As Kikuchi disease (subacute necrotizing lymphadenitis) represented a significant cause of prolonged fever, it should be considered if a patient has neutropenia with lymphadenopathy. Undiagnosed patients with prolonged fever (27.5 percent) have increased over previous studies.

• Journal of agricultural medicine and community health
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• v.27 no.1
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• pp.155-164
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• 2002

Hypertension is the most frequent disease of chronic circulatory diseases and major intermediate cause or risk of the cerebrovascular disease which is a leading cause of death in Korea. Therefore, management of hypertension is an important issue in Korean healthcare. Especially, therapeutic compliance of hypertensives is very important because the hypertensive patients should receive anti-hypertensive treatment as long as the condition exists. However, many patients drop out of treatment, which is a major problem that needs to be solved through a hypertension control program. This study was carried out to provide basic data and counter measule for the hypertension control program in the community which aimed to keep the patients receiving treatment continuously. In order to investigate compliance of hypertensive patients during three months follow-up and the rate of control of hypertension, the data were collected during February, 2001, by reviewing medical records of 295 hypertensive patients who had been registered to Gunnam-myeon health subcenter before November, 2000. The author also study the dropout reasons by interviewing 58 patients among 68 dropout patients. The results were as follows: 1. Among the 295 subjects, 108(36.6%) were male and 187(63.4%) were female. Statistically, female hypertensives had a higher mean age than male(64.6 vs 66.3, p<0.05). 2. The 54.9% of the patients took anti-hypertensive medicine continuously for the past three months. And 19.3% had drug intermittently, and 25.8% dropped out of treatment. 3. Among several variables, such as sex, age, health insurance, the time taken from a patient's village to the health subcenter, only the last one was found to be significantly related to therapeutic compliance in the contingency table analysis. 4. The dropout reasons by multiple response were as follows, 'no symptom or no problem' (23.9%), 'change to other hospitals'(19.4%), 'geographical barrier'(17.9%), 'change to a neighborhood drugstore' (14.9%), 'immobility'(7.5%), 'economic barrier'(6.0%), 'unsatisfactory services of the health subcenter'(4.4%). 5. The mean blood pressure of 295 subjects was $144.9{\pm}12.9/86.88{\pm}8.6mmHg$. 6. The 32.5% of the subjects were controlled below 140/90mmHg. Conclusions: In order to improve the low rates of treatment and control of hypertension in rural hypertensives, a more active and systematic hypertension control program, including out-reaching follow-up management, is required in rural area. Especially, for health education of hypertensive patients, emphasis should placed on correcting wrong attitude toward hypertension.

• The Journal of Korean Academy of Prosthodontics
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• v.52 no.4
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• pp.287-297
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• 2014

Purpose: The purpose of this study is to examine the impacts of infection control education on dental hygienists' perceptions for hepatitis B and their behaviors. Materials and methods: Study participants were chosen by random selection among dental hygienists working in Seoul, Korea. A total of 150 questionnaires were sent out for the survey from April 2013 to May 2013, of which 140-excluding incomplete responses-were used for the study. Chi-square tests and t-tests were used (SPSS 19.0), and post-hoc analysis was performed as well. The maximum significance level was 0.05. Results: Average 1.53 times infection control education was taken, but dental hygienists' perceptions for hepatitis B and their behaviors did not show statistical differences whether the education was done or not. Practices to prevent infection showed differences depending on categories, especially disinfection and sterilization were well performed by educated group. The most common reasons for not taking the education and noncompliance with infection prevention guidelines are lack of time and opportunity due to busy schedule. Conclusion: 1. The more highly educated, the greater number of patients per day, and the greater size of hospitals, the better infection control education was conducted. 2. Although hepatitis B is one of the most common chronic liver diseases in Korea, no significant correlation between perceptions of hepatitis B and infection control education was found. 3. Dental hygienists who received infection control education performed more efficient practices for protection against infections than those who did not.

• Korea Journal of Hospital Management
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• v.8 no.3
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• pp.72-91
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• 2003

The purpose of this study is to investigate the recognition of health information managers, and to analyze the level of job satisfaction and organizational commitment of medical record technicians. The data for this study were collected through a self-administered survey with a structured questionnaire to 172 subjects from medical record technicians working in hospitals in Seoul and Gyeonggi Province as well as the faculty of medical schools across South Korea. In this analysis frequency, t-test, ANOVA, factor analysis and structural equation model were used. The main findings of this study are as follows: 1. As for recognition of the seven dimensions in the role of health information managers, the role as clinical data specialist received the most positive feedback, followed by document & repository managers, patient information coordinators, health information managers, data quality managers, security officers and research & decision support analyst. 2. The level of job satisfaction among medical information handlers and managers averaged 3.14. In terms of the factors in the work environment concerned with job satisfaction, being able to work independently and as team players reached the top among 6 factors with the average of 3.39, followed by professional position, salary & rewards, expectations for job performance and administration. 3. The average rate of organizational commitment stood at 3.09. Respondents tend to be focused on present tasks rather than future-oriented tasks. 4. The result of the analysis based on the relationship between recognition as health information managers, job satisfaction and organizational commitment found that all analysis are statistically meaningful. The more the respondents were aware of their roles as health information managers, the more they tended to be committed to their work and satisfied with their work. The more the respondents were committed to their work, the more satisfaction was seen. The effects of recognition as health information managers on organizational commitment measured 0.27 and for job satisfaction it was 0.17. The effects of organizational commitment on job satisfaction stood at 0.71. The feasibility of the model meets the standard at Chi-square value of 66.755 and the P value of 0.057. The Normed Fit Index (NFI) of 0.930 was in compliance with the standard for model feasibility and the squared multiple correlation coefficient of this model was 8% in organizational commitment and 60% in job satisfaction.

• Korea Journal of Hospital Management
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• v.14 no.4
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• pp.149-162
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• 2009

The purpose of this study is to design strategic hospital service based on each hospital's features. For this study, an assessment was conducted by 398 in-patents of one university hospital located in Seoul. The self-questionnaires, which were investigated from Oct. 15th to 29th in 2008, compared central reception desk with ward reception desk in satisfaction and re-use rate of patients. The major results of this study are as follow. First, according to each reception desk user, they have different satisfaction of it. As for the staff kindness, admission procedure, discharge procedure and manner of staff, those made patients be gratified as well. Second, when it comes to the intention of re-use, there were no significant features between them. Only convenience in admission and discharge procedure, however, was an attractive factor for the recommendation. Third, this study found out the reasons for higher re-use rate of central reception desk users. Regarding service, they were contented with the time for test and treatment. As for the hospital service, they would like to re-use this hospital because of convenient steps of paying interim fee and getting certificates. Forth, this study found out the reasons for higher re-use rate of ward reception desk users. As a point of hospital service view, they responded that respected privacy, hospital facility and general service were good for staying. As for the manner of staff, they mentioned nurses and staff in charge and whole staff members were kind. When it comes to the procedures of patient management, steps of discharge and paying interim fee were convenience. In conclusion, the results of this study suggest that providing a ward reception desk service can boost the satisfaction and re-use rate of in-patients. Furthermore, this strategic management method would be good for not only cutting the moving line but also efficient in-patient care system. These results can be used for the strategic hospital marketing field, as well. Even though this study has a limitation of the targeted populations which were only in a ward reception desk running hospital, it can say that having competitiveness in satisfaction of hospital service is good for promoting and differencing each hospital. Consequently, whole general management system would be adjusted first for differencing each hospital; however, this sort of additional factor should be concerned as well. I expect that this study would give meaningful data for designing strategic and differencing marketing method to lots of hospitals.

• The Korean Journal of Emergency Medical Services
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• v.8 no.1
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• pp.149-160
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• 2004

Background : To save out-of-hospital cardiac arrest cases is a major concern for Korea. Cardiac arrest is a very common problem, with > 18,000 cases dying each year in Korea. Overall, survival to hospital discharge remains poor. Resuscitation has become an important multidisciplinary branch of medicine, demanding a spectrum of skills and attracting a plethora of specialities and organizations. Since the "Utstein Style" was advocated in 1991, many reports about out-of-hospital cardiac arrest have been published based on this guideline. These differences prevent valid inter-hospital and international comparisons. However, we do not know the true effectiveness of resuscitation. There are no guideline for reviewing, reporting, conducting research on resuscitation in Korea. This study evaluated the out-of-hospital factor associated with survival discharge of out-of-hospital cardiac arrest, was especially to provide basic data for the unified reporting guideline of resuscitation in Korea. Methods : From January 1990 to July 2004, we collected data about out-of-hospital cardiac arrest at Wonju Christian Hospital(WCH-CAD), Ewha Women University Mokdong Hospital(Ewha-CAD), I used same record form based on the "Utstein Style". The "Utstein Style" is internationally recommended guidelines for reporting outcome data from resuscitation events. Results : Resuscitation was performed in 1443 out-of-hospital cardiac arrest patients at 2 hospitals. Five hundred eighty(40.25%) patients recovered the spontaneous circulation at least once and One hundred sixty eight(11.66%) patients discharged alive. Initial EKG showed Ventricular Tachycardia/Ventricular Fibrillation in One hundred thirty five(9.33%) patients, asystole in one thousand nine(69.73%) patients and other rhythms in one hundred thirty nine(20.94%) patients. Among one hundred two cardiogenic cardiac arrest patients, two(2.0%) patients was discharged alive. Conclusion : Overall survival rate of out-of-hospital cardiac arrest patients was 11.66% which was poorer than that of the western country. The proportion of the cardiogenic cause was 33.38% which was only half of the western country. VT/VF is relatively not common ac a initial EKG rhythm. These differences might be to due difference in the prevalence pattern of out-of-hospital cardiac arrest as well as prematurity of the EMSS. It is needed that the best survival can be achieved if all following links have been optimized : rapid access, early CPR, early defibrillation, early ACLS.